Family Practice Coding: Rules To Follow Before Giving New Problem Credit

By Author: Angela Martin
Total Articles: 205
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Your family practice physician gets more medical decision making points for a new problem. However when his partner has already seen the patient for the problem, determining whether the problem is still new proves elusive. Here's the low down on the rules you have got to follow prior to giving new problem credit.

Capture more MDM points depending on the status of problem

Under Medical Decision Making Number of Diagnoses or Treatment Options, the standard audit worksheet gives 1 point for a stable or improved established problem and two points for an established problem that's worsening. However, for a new problem, the doctor gets a whooping 4 points when additional workup is planned and 3 points when no workup is planned. The problem has to be new to the examiner.

Catch: Is the problem thought of as new when a doctor in a group tends to an established patient and this is the first time the doctor is treating the patient?

Check your policies interpretation of New

The answer lies on your contractor. For Wisconsin Physician ...
... Services, the Medicare part B contractor for Wisconsin, Illinois, Michigan, and Minnesota, ‘new' applies to the whole group.

For more on family practice coding, sign up for an audio conference. When you sign up for one, you'll get the skinny on the rules you've got to follow prior to giving new problem credit apart from lots of other family practice coding tips to help you get the reimbursements you deserve.

When you sign up for one, you can attend one from the comforts of your office or meeting room. What's more, even if you miss out on a family practice coding conference, you can always fall back on CDs and MP3s to take you through the entire event. You even stand to gain CEUs on attending one.